Disintegration, love and hope are the key factors in Deborah Shouse's Love in the Land of Dementia: Finding Hope in the Caregiver's Journey from The Ceativity Connection Press, Kansas City.

Some books on the topic, Alzheimer's, are clinical dissections of the illness. Others become too saccharine, as if searching for an artificial sweetner for an always-bitter situation.

The strength of Shouse's retelling of her mother's gradual descent is in the simplicity of the writing. The book reads like an early motion picture, more often in black and white than color, images flickering in and out, off and on...snapshots in seconds as agonizing months go on. The early signs of her once-vibrant artist mother's limitations are almost unnoticeable. Then reality begins to sink in, gradually. Page by page, with heavy reliance on scene-setting and bits of dialog, the author tells of the onset and gradual progression. From her mother's life at home in Memphis through an inevitable move to be closer to her daughter, the story is compelling. It is also all too familiar to many. What appears to be the natural confusion and forgetfullness of age becomes, in the end, inability to cope, to accomplish simple daily tasks, to distinguish reality from fantasy.

Some lessons, some moments of comfort, emerge from the daugher's visits to her mother. She may not know exactly what she will see, or feel--or not feel--when she visits her in a nursing home and, ultimately, in hospice care. But the love, the hope, the memories, are always there. Both are learning to cope; the once-strong, older one is becoming the child who needs care. Shouse's father, a former radio disc jockey, even tries old songs, old movies, his disappearing wife's love of Tom Cruse films--but nothing brings back the strong, talented lady he married. Titles of the poignant sections of vignettes speak volumes. "The Stranger Who Used to be My Mother" includes one section labeled "The Black Hole," for example. "In the end, only love is left," Shouse says as her mother gradually gives up more and more of who she once was.

"Her greatness remains in this simple gift she shows us," Shouse writes. "When all the ordinary things are gone, the spirit can still remain. Love doesn't necessarily conquer anything or all, but it can outlast the rational parts of life." Coping, surviving and caring are not easy. As the tv screen and newspapers show us, "every day there is war; every day there is victory."

Frustrated that she cannot do more as employees of the home try to make her mother's last months more bearable, Shouse wonders, "what kind of daughter am I, that I stand back and watch?" Her self-doubt begins to arise more often. "I understand the progression of the disease," she says. "What I don't understand is how much I would miss having a mother."

The simply-told stories that span seven years are touching demonstrations of one person's never-ending attempt to stay connected with her mother. The tales are honest, realistic lessons in ways both patient and caregiver change as their relationship changes. Yes, there is fear, and uncertainty, and self-doubt. But there is also love, hope and the beauty of simplicity--guides for all of us, whether we are affected by Alzheimer's or not.

Title - Love in the Land of Dementia: Finding Hope in the Caregiver's Journey